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General NPI Number Information
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NPI Number | 1871353417
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Entity Type | Individual
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Provider Name | LISA MARIE DANIEL LPC, LSSP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 3831 BLACKJACK RD
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City | JEFFERSON
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State | TX
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Zip | 75657-8296
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Country | US
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Telephone | 903-268-9958
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Fax |
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Provider Business Mailing Address
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Address Line | 3831 BLACKJACK RD
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City | JEFFERSON
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State | TX
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Zip | 75657-8296
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Country | US
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Telephone | 903-268-9958
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 86674
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 32985
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 86674
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License Number State | TX
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